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One Size Doesn’t Fit All

One of the most difficult things in life is to reach out for support. Recurring discouraging experiences can compound the complexity. My clients tell me that they have spent years, if not decades, in a ‘revolving-door-like’ mental health system without much improvement.

Choosing the right mental health support is crucial to resolving ongoing mental health problems. To help you navigate the world of mental health care, I’m highlighting some points so that you can make a more informed decision when needed.

3 constrains of the mental health rebate system

The Medicare rebate system has its constrains when used for mental health support

1. You must receive a diagnosis to qualify for a rebate.

In order to receive mental health support (bulk billed or Medicare subsidised psychological care) you need to obtain a referral from your GP. You cannot get this referral without being diagnosed with a mental illness, i.e. with one of the conditions outlined in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (or DSM-5).

From that time on, your private information – presenting issues, diagnosis, medications, treatment plan and progress report – will be recorded in what is known as your Mental Health Plan. In some cases this is necessary and you may not have to worry about it. As long as you remember, it will stay on your medical records even if you ‘just’ had problems due to relationship, work issues or life transitions. However, this might create a problem in the future when dealing with insurance companies, child adoption agencies, certain job applications or employers.

2. The need to fulfil the requirement to qualify for Medicare rebate and private insurance cover is the priority of the mental health system.

Consequently, when you seek advice from your GP on how to handle your strong emotions, troubled sleep pattern or escalating comfort eating, they often prescribe medication. This happens despite towering evidence that various ‘talking therapies’ work better and are more sustainable than medicine-only treatment. The medication route focuses on symptoms reduction also risks creating prescription drug dependency. As a minimum contingency your GP should encourage you to seek counselling to accompany your treatment.

3. This tightly regulated rebate system restricts patients’ choices.

If not medication, your helping professional, who needs to comply with the treatment that Medicare or the insurance companies, can often only offer you a ‘one-size-fit-all’ treatment. They most probably offer Cognitive Behavioural Therapy (CBT) – or ACT, DBT, MBSR, other cognition focused modalities – to treat a wide range of conditions that you suffer from.
The reason for using CBT as a go-to treatment is because it has been around a very long time and has proven easy to measure its efficacy. Research suggests it is effective to a certain degree in short term symptom reduction. But it has shown to be less effective 6 months post intervention for clients with attachment injuries, anxiety, depression, developmental PTSD, personality disorders and addictions, to name a few.

You Have a Choice in Selecting your Therapy and Therapist

You have choices when choosing mental health support that’s right for you

Ask yourself ‘what do I really need’, ‘what type of care would I welcome most’

You may need client-centred, trauma-sensitive and holistic care. More than that, a counsellor or psychotherapist who can ‘see’ you, ‘connect’ with you and can form a compassionate therapeutic relationship with you.

Would you benefit more from receiving treatment tailored to your specific needs? Look around before you choose and thoroughly search what’s available to you. Find out what registered counsellors and psychotherapists in your area have to offer.

Aim at fundamental changes instead of settling for a ‘quick fix’ to only address your symptoms and not the underlying causes

Although we generally tend to opt for the quick and easy solutions, when it comes to healing from ongoing, life limiting problems we should aim at complete recovery. Symptoms like anxiety or the tendency of ending up in harmful relationships are often signs of underlying problems. The most prevalent of these problems are childhood trauma and attachment injury. Often people don’t realise how the minds and issues of their parents or caregivers impacted on their own minds, beliefs, behaviours and feelings.

The way to heal from the impact of past adverse experiences that shaped the way you feel, think and act is through supportive and compassionate relationships.

Therapy is a restorative relationship that can rewire your brain

The emotional safety of a therapeutic relationship can demonstrate that you can safely connect with someone, trust them and feel they trust you. This process is hard to quantify in a ‘double-blind randomised control trial’ (the gold standard of research studies) but fortunately the scientific data supporting this approach is growing fast.

A client-centred, trauma-sensitive therapist with a repertoire of treatments to choose from can help you develop self-compassion, to recognise your needs and to help you move on from past-rooted, dysfunctional patterns. You’ll see yourself and your relationships in a different light, you will change focus and then start making empowered choices. The first one of which is choosing the right therapy for yourself.

This TED talk from Eleanor Longden provides a vivid, real-life story of how different the two pathways described above are.

Eleanor Longden: Voices in my head

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